Cannabis for Pain: An M.D.’s Advice

• If you’re ready to start using cannabis for pain, Dr. June Chin can help. 
• After discovering how medical cannabis can be a game changer for chronic pain, Dr. Chin began helping others integrate cannabis into their health treatments. 
• Many women are turning to medical cannabis for pain relief and health issues in lieu of prescription medications that aren’t as effective. 

13-minute read

Why use cannabis for pain?

Many of us have ditched Big Pharma drugs in favor of more natural health and wellness treatments. One of the most common is using cannabis for pain, especially chronic pain. We’re finding that cannabis and CBD products can be as effective as prescription medications for treating chronic pain—but minus the side effects. Women, especially, have traded in their Advil for CBD tinctures, salves, and prerolls. With legalization spreading across the country, old taboos around cannabis are diminishing. More importantly, doctors can now incorporate cannabis into their arsenal of treatments. That’s Dr. June Chin’s specialty. We sat down with Dr. Chin to get the facts about how cannabis can alleviate chronic pain. Here’s what you need to know.

You’re an expert in the prescription of cannabis for pain—how did you get into this speciality?

As a teenager, I was diagnosed with ankylosing spondylitis (AS). AS is a progressive type of arthritis that affects the spine, pelvis, hips, and back. This disease causes extreme stiffness and nerve pain. I spent my younger years trying conventional treatments. That included epidurals, narcotics, muscle relaxants, acupuncture, and physical therapy. But the pain was unrelenting. By the time I got to medical school in San Francisco, I was having difficulty standing for long periods in the operating room. One of the attending physicians saw this and asked me about it. I told him I had AS. I explained that I couldn’t take the meds I needed for relief. They made me drowsy and foggy while doing rounds or attending a 4-hour hip-replacement surgery. 

Turning to less conventional pain relief treatments

Here I was in a hospital, surrounded by great medical minds. But I was disappointed to find nothing that could help my condition. The attending physician and my mentor, Dr. Levine, pulled me aside and handed me a little brown dropper bottle.

CBD oil for pain

He didn’t call it CBD oil. He just said it was a different type of cannabis plant. I was mortified but desperate. As a medical student, my first thoughts were dire. “You’re offering me pot? You want to make me a drug addict?” I grew up in the Bronx, and there was a huge social stigma around marijuana. Kids who smoked weed were either dropouts or involved in gangs. I also grew up in a very traditional Chinese household. My parents believed in Reefer Madness—the false propaganda that weed led to psychosis and schizophrenia. The tincture Dr. Levine handed me smelled like a combination of alcohol, wet dog, and grass. I didn’t know what to think. But, to my amazement, it worked very well. The pain and inflammation of my arthritis decreased dramatically. My AS stopped progressing, and my health improved. 

Forming a more positive relationship with the plant

Even though California legalized medical cannabis in 1996, I didn’t dare tell anyone I was using it. I was a young doctor. I didn’t want to jeopardize my career. But once I got my health back, I decided to learn more about cannabis. I started to investigate how it helps manage pain and improve people’s overall health and wellness.

Why do you do what you do?

I suffered in pain for a long time. So, I know what it feels like to tell your doctor, “I’ve tried everything, and nothing has helped.” Now, I’ve been helping patients integrate medical cannabis into their health and wellness for over a decade. Cannabis changed the trajectory of my life. Had it not been for cannabis treatment, I wouldn’t have been able to finish medical school and become a doctor. I had an educational advantage because I did my medical school training in California. They legalized medical cannabis back in 1996. I was in the middle of a switch box and was able to engineer my circumstances to learn holistic, integrative cannabis medicine.

What’s different about using cannabis for pain?

In medical school, there is “this is how we’ve always done it” syndrome. That’s the conventional medicine model. But how did we come to believe that prescription medication is the only, or most effective, way to treat disease? That’s a reductive approach. In medical school, we’re trained to find what’s bad in your body and get rid of it. This is only part of the puzzle. We often get locked into this one-size-fits-all thinking. There’s no one-size-fits-all treatment when it comes to using cannabis for pain management. Throughout history, botanical remedies have been a mainstay of folk medicine in many cultures. Phytocannabinoid medicine is on that list.

How has using cannabis for pain been a game changer for you?

I’m a chronic pain survivor. As a result of my experience, I decided to dedicate my medical career to finding effective, integrative, and holistic approaches to patient care. To reach the best outcome, my patient and I form a therapeutic alliance and inform each other. My goal as a doctor is to help patients reach their optimum health. We do that through prevention and proper nutrition. It’s always done with support, empowerment, and education. The medical cannabis movement should be a wake-up call to our current healthcare system. That system is very poor at addressing how to prevent disease.

What tips can you share for anyone looking to start using cannabis for pain management?

Over the last 15 years, my medical cannabis career has been based on anecdotal and clinically-applied evidence. I help patients integrate medical cannabis into a full-scope general and holistic medical practice. Cannabis is an empowering medicine. The plant is unique. There’s no precedent for it. There’s no other drug in the world that we’re using both recreationally as well as for therapeutic uses. The historical record for the safe use of cannabis is also unparalleled.

Where does cannabis fit into the future of medicine?

The future is preventative medicine. There’s a whole universe of regenerative medicine, nutritional medicine, and preventative medicine. Those models mean that we need to create health from the ground up. That includes medicinal cannabis. And that’s teaching us all to rethink medicine. There are so many new ways we can treat, heal from, and even prevent disease altogether.

The first step in your journey of using cannabis for pain

Find a health professional who resonates with you. Find an M.D. who’s your partner in health and healing. Don’t go with someone you’re intimidated by and can’t speak openly with. I’m convinced that health coaches, nutritionists, and allied healthcare providers will play just as big a role as doctors and other licensed clinicians in ushering in the future of medicine. Find the right health practitioner for you!

How does dosing work—especially for women?

1 out of 4 women in America today take a psychiatric medication. That’s compared with 1 in 7 men. Women are nearly twice as likely as men to get a diagnosis of depression or an anxiety disorder. Pharmaceuticals improve the lives of many women. But, for others, they aren’t necessary. Or they can cause side effects as bad as the underlying conditions. The increase in prescriptions for psychiatric medications, often by doctors in other specialties, is creating a generation of overly medicated women. It makes me wonder if women are making decisions based on sound medicine. Or are they responding to peer pressure or advertising? 

Tell us about the stats on antidepressant prescriptions

Right now, antidepressants are used in the clinical management of anxiety disorders, chronic pain, and even hot flashes. That’s insane. Also, when a prescription is written for every individual symptom, basic connections are overlooked. For example, more than 90% of depressed patients complain about difficulties falling asleep, sleep disruption, or early morning awakenings. Sleep disruption and depression are closely linked. ¾ of depressed patients also suffer from insomnia symptoms. But one pill for each symptom clouds these obvious links.

More women are turning to cannabis

Women, as a group, know they’re being overmedicated. Many are finding ways to wean themselves off. In 2018, the cannabis delivery service, Eaze, reported that the number of women buying cannabis products from them almost doubled. And, according to Brightfield Group, women now make up 51% of all U.S. cannabis consumers. 

Cannabis helps women with more than chronic pain

Net net: cannabis can be effective in addressing many female-specific physical and mental health issues. That includes chronic and acute conditions. You can also use cannabis to optimize overall feelings of well-being. The plant can provide beneficial cannabinoids and terpenes. Each of these can have a positive impact on women’s health. Microdosing at various times throughout the day is helpful for women to get ahead of their chronic pain. But the right ratio of cannabinoids is key, too.

Can you share any rules of thumb for using different forms of cannabis?

We have to ask, “What are your goals?” Do you need it to be fast acting? Do you need a sustained, slow release? Or immediate localized muscle relief? This dictates what form factors (e.g., flower, topicals, concentrates, etc.) you should start experimenting with. Then use a combo of various form factors to meet your specific pain relief needs.

What are your personal go-to strains for pain in the a.M. and p.m.?

I like Cannatonic for day and Blue Dream at night.

How does the use of cannabis for pain management in women differ from treating chronic pain in men?

Because of estrogen, women are more sensitive to the effects of chemical compounds. In cannabis, that includes both cannabinoids and terpenes. But that’s particularly true of THC. As women, we go through several distinct physiological changes during our lifetime. Those stages drastically alter the amount of estrogen in our systems. Understanding how cannabis can play a part in regulating hormonal flux and easing these transitions can be a health and wellness revelation for women.

Do you have any advice for women who are concerned about cannabis stigma? 

For many decades, my parents were against my career as a medical cannabis physician. In Asian American culture, there’s always fear around the cannabis plant. Cannabis is considered the worst drug in Asian communities. That’s because cannabis was thought to be the “drug” that kids were most likely to come into contact with. Ironically, China has been using the plant for over 10,000 years. And China legalized CBD in 2015! This week, I was in the supermarket with my uncle. He’s still against cannabis, CBD, and anything derived from the plant. I pointed to the sign at the supermarket aisle. “Look, CBD is sold here right next to Cheerios!” My uncle’s response was, “Well, I guess CBD is not the ‘bad’ part of the plant”.

5 Ways to Break the Stigma Around Cannabis

First, be a responsible cannabis consumer. Second, arm yourself with cannabis facts. Third, share your story. Fourth, support diversity, inclusion, and education in the cannabis industry. Fifth, support reform efforts in a meaningful way.

The statistics about women using cannabis for pain 

Finding out how many women are currently using cannabis can be challenging. The statistics are all over the place. Plus, many women are still silenced by the stigma. Also, women are often not taken seriously. When women have pain, they’re told to suck it up. Just keep going. You have to go to work. You have to take care of your children, partner, and family. Just get on with your life. And before you know it, the pain becomes “normal”. We adapt to it. 

women aren’t always listened to or taken seriously

Women with chronic pain are some of the strongest women I know. They’ve been living with this kind of underlying pain for so long. Health practitioners routinely minimize women’s experience of pelvic pain, IBS, insomnia, and sexual dysfunction. These complaints are often dismissed as psychological rather than physical conditions. Despite multiple trips to doctors and specialists, some women go undiagnosed for years. All the while, they’re told that their symptoms could be stress-related.

You treat patients of all ages—what’s the difference between how you treat adults and children?

In my practice, I’m seeing the sickest of the sick. Children who have intractable epilepsy. That includes seizures as a result of traumatic brain injury, spinal cord injuries, cancer, and colitis. I get referrals from other specialists to help treat young patients with medical cannabis after they’ve exhausted pharmaceutical and other forms of treatment. For children with cancer, medical cannabis can help with nausea and pain. Cannabis stimulates their appetites while they’re being treated with chemotherapy and radiation. For children with intractable epilepsy, parents report that cannabis treatment makes seizures less frequent, less severe, and shorter. But there can be side effects. Cannabis can interact with other drugs the patient is taking. To prevent negative effects, I monitor my patients very closely and work holistically with the child’s other doctors.

Cautions for children and medical cannabis

I also want to caution that cannabis can affect children’s and teens’ brains. Adding cannabis to a normal, functioning endocannabinoid system may actually interfere with a developing brain. Medical cannabis can be a game changer for kids who don’t respond to traditional medications. The children who come into my office are special cases. These are children who can’t find solutions with conventional treatments. There are very few physicians specializing in cannabis medicine who are willing to treat children and work closely with parents to monitor the child closely every step of the way.

What are the most common recommendations you give patients for chronic pain? 

Microdosing! That includes a 3 things. First, 1:1 ratio of CBD to THC. At night, 1:6 ratio of CBD to THC. For breakthrough pain during the day, a 2:1 of CBD to THC. For chronic pain sufferers, I recommend establishing a regular routine of 1:1 ratio of CBD to THC to stay AHEAD of the chronic pain. Don’t wait for a flare up. It takes the edge off. Patients can also synergistically use NSAIDS with a 1:1 ratio of cannabis. They complement each other. So they synergistically reduce pain by inhibiting endocannabinoid breakdown in the body. They’ll also reduce some side effects of THC. That can be helpful if you don’t want to feel sedated or euphoric. But, if you can skip the NSAIDs altogether, that’s a bonus. Regular NSAIDs use can eat away at your gut lining

What’s the scoop on the book you co-authored, Cannabis and CBD for Health and Wellness? Do you have plans to write another book?

As women and chronic pain survivors, our empathy, intuition, and determination help us to find a way to take charge of our own health. That defines the heart of this book. I recommend it to anyone who’s looking for a more integrative and holistic approach to their health and wellness.

Can you share any other cannabis initiatives you have in the works?

I’m also working with Risa Morimoto on an educational course on cannabis and women’s health. She’s the producer of House Hunters International and the popular YouTube channel Modern Aging. We’re launching next month! So please help me spread the word. We’re offering free webinars on September 30, October 3, and October 6. If you’re interested, you can sign up at www.cbdwomenshealth.co/webinar. You can learn more about the course in advance on YouTube here and here.

How can people keep up with your work on all things cannabis for pain management?

You can follow me on Instagram @drjunechin and on DrJuneChin.com

The information in this interview is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. 

Please consult your physician.